CEA 和 CA19-9 单独及联合检测在食管癌、胃癌和结肠癌中的对比研究（ROC 曲线分析）。
Comparative study of CEA and CA19-9 in esophageal, gastric and colon cancers individually and in combination (ROC curve analysis).
机构信息
Department of Biochemistry, S.M.S. Medical College & Hospital, Jaipur 302004, India;
Department of Radiotherapy and Oncology, S.M.S. Medical College & Hospital, Jaipur 302004, India;
出版信息
Cancer Biol Med. 2013 Sep;10(3):148-57. doi: 10.7497/j.issn.2095-3941.2013.03.005.
OBJECTIVE
To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers.
METHODS
The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic (ROC) curves were plotted.
RESULTS: Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined: in esophageal cancer, sensitivity=28%, negative predictive value (NPV)=61.72%, and AUC=0.742 (SE=0.05), with a significance level of P<0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 (SE=0.05), with a significance level of P<0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 (SE=0.04), with a significance level of P<0.0001. The sensitivity of CA19-9 was also evaluated: in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 (SE =0.05), with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE =0.05), with a significance level of P<0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.580 (SE =0.05), with a significance level of P=0.1670. The following were the sensitivities of CEA/CA19-9 combined: in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 (95% CI: 0.0159-0.322); gastric cancer, sensitivity=58%, NPV=70.42%, SE=0.072 (95% CI: -0.0866-0.198); and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 (95% CI: 0.137-0.415).
CONCLUSION
CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.
目的
确定 50 例健康受试者和 150 例食管癌、胃癌和结肠癌患者的癌胚抗原（CEA）和糖类抗原 19-9（CA19-9）的血清临床水平，单独和联合检测，用于诊断。
方法
比较两种标志物的单独和联合检测的敏感性，特异性为 100%。绘制接收器工作特征（ROC）曲线。
结果
癌症患者的血清 CEA 水平明显高于对照组。CEA 的灵敏度为：食管癌，灵敏度=28%，阴性预测值（NPV）=61.72%，AUC=0.742（SE=0.05），P<0.0001；胃癌，灵敏度=30%，NPV=58.82%，AUC=0.734（SE=0.05），P<0.0001；结肠癌，灵敏度=74%，NPV=79.36%，AUC=0.856（SE=0.04），P<0.0001。还评估了 CA19-9 的灵敏度：食管癌，灵敏度=18%，NPV=54.94%，AUC=0.573（SE=0.05），P=0.2054。胃癌，灵敏度=42%，NPV=63.29%，AUC=0.679（SE=0.05），P<0.0011。结肠癌，灵敏度=26%，NPV=57.47%，AUC=0.580（SE=0.05），P=0.1670。CEA/CA19-9 联合的灵敏度为：食管癌，灵敏度=42%，NPV=63.29%，SE=0.078（95%CI：0.0159-0.322）；胃癌，灵敏度=58%，NPV=70.42%，SE=0.072（95%CI：-0.0866-0.198）；结肠癌，灵敏度=72%，NPV=78.12%，SE=0.070（95%CI：0.137-0.415）。
结论
CEA 对结肠癌的敏感性最高，CA19-9 对胃癌的敏感性最高。联合分析表明，与结肠癌相比，食管癌和胃癌的诊断敏感性有所提高。
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